There are three glands known as the sex glands that are part of the endocrine system of the human body. Although more glands and organs are included in the endocrine system, the glands that are connected to human reproduction are:
All three glands secrete hormones that are important for procreation. The pituitary gland is a tiny gland, about the size of a pea that is found at the base of the brain. This gland secretes a hormone called prolactin, a hormone that is necessary for both men and women in terms of sexual function. Prolactin is released at various times throughout the day and night and its main function is to stimulate breast milk production after childbirth. It is quite normal for a woman to have high prolactin levels during pregnancy and breastfeeding.
What Prolactin Does in Normal Situations
Normal levels of prolactin in a woman's body do not inhibit the release and function of other important hormones. However, if the levels are too high, it can affect ovulation and the menstrual cycle by inhibiting follicle stimulating hormone (FSH) and gonadotropin releasing hormone (GnRH). If there is no ovulation, then the result is infertility. Anovulation, or the absence of ovulation can then affect menses by causing irregular periods.
Prolactin lowers the levels of sex hormones (estrogen and testosterone) in both men and women. Too much of this hormone lowers the levels to the place where sexual as well as menstrual dysfunction occurs. Increased levels of prolactin may be due to a disease or the use of certain types of medications. Often, the cause of raised levels of this hormone is due to a small prolactin-producing tumor sitting on the pituitary gland called a prolactinoma. It occurs mostly in women and is almost always benign. Pressure from other tumors might also cause an increase in prolactin production.
Some of the Results of High Prolactin Levels
There are some results of high prolactin levels that are the same for both men and women, including infertility, low sex drive and bone loss. Additionally, women may have:
· No periods or irregular periods
· Vaginal dryness
· Breast discharge even though they are not nursing
· Adolescent girls may also experience both menstrual problems and breast discharge
· Erectile dysfunction
· Decreased body hair
· Decreased muscle mass
· Boys may have delayed puberty and low testosterone levels
A person with a large prolactinoma may encounter headaches and sight problems due to the pressure of or injury by the tumor to the optic nerve, which is near the pituitary gland. Yet, even though these symptoms are commonly found in those with prolactinoma, there may be no indications of the tumor.
Hyperprolactinemia is detected with a blood test that measures the prolactin level. Usually, only one test is required to find the problem and the doctor will check to ensure that any medications a person may be taking are not causing an increase in prolactin levels.
The Various Possible Causes of High Prolactin Levels
Another cause of excess prolactin in the system is an underactive thyroid gland, called hypothyroidism. Thyroid hormone levels are checked by a blood test and if the doctor thinks there is a tumor, an MRI of the brain and pituitary gland is done to confirm the suspicion. For women of childbearing age, the first thing the doctor will rule out is pregnancy, which naturally causes prolactin levels to rise. Kidney or liver disease can also raise prolactin levels, so a medical history is necessary to rule out the possibilities of either of these diseases. Medications, as mentioned earlier, can have an effect upon prolactin levels. Some that can cause the levels to rise include:
· Opiate painkillers
· Metoclopramide (for heartburn or gastro reflux)
· Antipsychotics (for serious mental illness)
· Some medications for high blood pressure
· Medications for depression
· Medications for ulcers
Treating Infertility Condition
If a person does not have serious symptoms, then treatment may not be necessary. Depending upon the cause of the rise in prolactin levels, treatment may be as simple as changing medications. Such is the case with medicine-induced hyperprolactinemia. However, if, after a time off the medicines, the levels remain high using another type of drug is the next step. Sometimes estrogen or testosterone treatments are given to men and women who present with infertility, low sex drive and low bone mass.
To treat prolactinoma, a tumor on the pituitary gland, the treatment begins with a prescription medicine to lower prolactin production thereby shrinking the tumor's size. Usually, the tumor will die within a two year period and the individual will be weaned off the medication. If the tumor doesn't shrink, then a higher dose of medication may be used. Surgery is a last resort and often is not necessary.
Learn more about the many facets of prolactin and how they affect fertility in this section.